title: Risk assessment of liver-related events using transient elastography in patients with chronic hepatitis B receiving entecavir.
abstract: OBJECTIVE
  We investigated whether liver stiffness (LS) values can predict liver-related events (LREs) development in patients with chronic hepatitis B (CHB).
  
  
  BACKGROUND
  LS values using transient elastography provides accurate assessment of liver fibrosis in patients with chronic liver disease.
  
  
  METHODS
  Between June 2007 and May 2010, a total of 162 patients with CHB who completed 2-year entecavir (ETV) treatment were evaluated. The primary endpoint was LRE development (hepatic decompensation, hepatocellular carcinoma, or liver-related death) during the 2-year ETV treatment.
  
  
  RESULTS
  The median age of the patients (99 men, 63 women) was 51 years, and the median LS value was 14.8 kPa. During the 2-year ETV treatment, 15 (9.3%) patients experienced LREs. On univariate analysis, age, the proportion of patients with liver cirrhosis, platelet counts, and baseline LS values were significantly associated with LRE development (all P<0.05). Together with age, multivariate analysis identified baseline LS values as an independent predictor of LRE development (P=0.046; hazard ratio, 1.040; 95% confidence interval, 1.101-1.084). The cutoff LS value maximizing the sum of sensitivity and specificity was 12.0 kPa (area under the receiver operating characteristics curve, 0.736; P=0.003; sensitivity, 93.3%; specificity, 42.2%). In addition, the changes in LS values between baseline and 1-year ETV treatment showed significant correlations with LRE development (P=0.030).
  
  
  CONCLUSIONS
  Our data suggest that LS values are predictive of LRE development during 2-year ETV treatment in patients with CHB. The potential role of LS value as a monitoring tool for predicting dynamic changes in the risk of LRE development during long-term ETV treatment should be investigated further.
authors.affiliation: *Department of Internal Medicine †Institute of Gastroenterology, Yonsei University College of Medicine ‡Liver Cirrhosis Clinical Research Center §Brain Korea 21 Project for Medical Science, Seoul, Korea.
authors.forename: Mi Na
authors.initials: MN
authors.lastname: Kim
authors.forename: Seung Up
authors.initials: SU
authors.lastname: Kim
authors.forename: Jun Yong
authors.initials: JY
authors.lastname: Park
authors.forename: Do Young
authors.initials: DY
authors.lastname: Kim
authors.forename: Kwang-Hyub
authors.initials: KH
authors.lastname: Han
authors.forename: Chae Yoon
authors.initials: CY
authors.lastname: Chon
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Ahn
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D019540:Area Under Curve; D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000401:mortality / Q000821:virology; D016009:Chi-Square Distribution; D054459:Elasticity Imaging Techniques; D005260:Female; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019694:Hepatitis B, Chronic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000821:virology; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000401:mortality / Q000821:virology; D017093:Liver Failure / Q000175:diagnosis / Q000401:mortality / Q000821:virology; D008113:Liver Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000821:virology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; C413685:entecavir; D006147:Guanine